ACTIONABLE INSIGHTS FOR PAYERS
Identify and curtail waste within provider organizations and payer systems.
Assess and improve provider performance and quality of care
Design and develop data reports and products to enhance the retention of current market share and attract new business by demonstrating cost containment and quality initiatives
Apply statistical research and custom analytics to integrated Pharmacy and Medical Claims data.
Identify outliers and instances of Fraud, Waste, and Abuse (FWA) among members and providers.
Identify instances and reasons for non-adherence, Evaluate the impact of adherence on overall healthcare cost, and calculating potential waste.
Conduct forecasting of annual projected medical and pharmaceutical growth rates
Develop pricing models for data-driven services
Evaluate the impact of adherence on overall healthcare costs, identifying reasons for non-adherence, and calculating potential waste.
